Provider Demographics
NPI:1790570182
Name:COGNITIVE HOMEOSTASIS, LLC.
Entity type:Organization
Organization Name:COGNITIVE HOMEOSTASIS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:
Authorized Official - First Name:KADORI
Authorized Official - Middle Name:NGIRABAKUNZI
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN-CNP, PMHNP
Authorized Official - Phone:513-549-7414
Mailing Address - Street 1:6590 WILLOW DALE CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9076
Mailing Address - Country:US
Mailing Address - Phone:513-549-7414
Mailing Address - Fax:
Practice Address - Street 1:6590 WILLOW DALE CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-9076
Practice Address - Country:US
Practice Address - Phone:513-549-7414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health